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经颅直流电刺激(tDCS)早期强化治疗青少年重度抑郁症的安全性和有效性:一项随机对照试验。

Safety and efficacy of early augmentation with Transcranial Direct Current Stimulation (tDCS) in adolescents with Major Depressive Disorder: A randomized controlled trial.

作者信息

Upadhyay Saumya, Agarwal Vivek, Arya Amit, Kar Sujita Kumar

机构信息

Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India.

出版信息

Asian J Psychiatr. 2025 Jan;103:104349. doi: 10.1016/j.ajp.2024.104349. Epub 2024 Dec 19.

DOI:10.1016/j.ajp.2024.104349
PMID:39733498
Abstract

BACKGROUND

Transcranial Direct Current Stimulation (tDCS) is an emerging modality with demonstrated efficacy in Major Depressive Disorder (MDD), however, there is paucity of research in adolescent depression. This study attempts to evaluate the safety and efficacy of tDCS in adolescents with MDD as an early augmentation to drug therapy.

METHODS

Adolescents with MDD aged 10-18 years were enrolled in the study and allocated to active or sham groups as per randomization. Sertraline was given in the range of 25-50 mg to each participant. After baseline assessments, 10 sessions of tDCS were given with 2 mA current for 20 minutes, keeping anode at left DLPFC and cathode at right DLPFC. Side effects were assessed and rating scales were reapplied at 2 weeks and then 6 weeks. Results were analyzed.

RESULTS

A total of 32 patients were analysed (15-active, 17-sham). At 2 weeks, the BDI and BAI scores of the true group were significantly lower than the sham group, and the reduction in the scores of the former was statistically greater. This significance did not persist at 6 weeks, and the reduction in the scores of the two groups was significantly different from baseline to 2-weeks and 6-weeks. Response and remission rates were higher in the active group at 6 weeks. Adverse effects were comparable.

CONCLUSION

tDCS is safe and effective for early augmentation of drugs in adolescents with MDD. However, effects do not last long after termination of sessions. Further studies are needed with a larger sample size and longer follow-ups.

摘要

背景

经颅直流电刺激(tDCS)是一种新兴的治疗方式,已被证明对重度抑郁症(MDD)有效,然而,针对青少年抑郁症的研究却很少。本研究旨在评估tDCS作为药物治疗早期辅助手段对患有MDD的青少年的安全性和有效性。

方法

年龄在10 - 18岁的患有MDD的青少年被纳入研究,并根据随机分组被分配到活性组或假刺激组。每位参与者服用25 - 50毫克范围的舍曲林。在基线评估后,给予10次tDCS治疗,电流为2毫安,持续20分钟,阳极置于左侧背外侧前额叶皮质(DLPFC),阴极置于右侧DLPFC。评估副作用,并在2周和6周时重新应用评分量表。对结果进行分析。

结果

共分析了32例患者(15例活性组,17例假刺激组)。在2周时,活性组的贝克抑郁量表(BDI)和贝克焦虑量表(BAI)得分显著低于假刺激组,且前者得分的降低在统计学上更显著。这种显著性在6周时未持续,两组得分从基线到2周和6周的降低有显著差异。活性组在6周时的缓解率和有效率更高。不良反应相当。

结论

tDCS作为药物早期辅助手段对患有MDD的青少年是安全有效的。然而,治疗结束后效果持续时间不长。需要进行更大样本量和更长随访时间的进一步研究。

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